Pulmonary Gas Exchange in Life-Long Nonsmoking Patients with Diabetes mellitus

Minette, P.; Buysschaert, Martin; Rahier, Jacques; Veriter, C.; Frans, Albert

doi:10.1159/000029332

Cited by 16 publications

(13 citation statements)

References 15 publications

(17 reference statements)

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“…Autopsy findings in human diabetics have demonstrated the presence of a thickened alveolar epithelial and pulmonary capillary basal lamina [10, 11, 12]. On the other hand, Minette et al [13]found a normal transfer factor, transfer coefficient, oxygen consumption and arterial blood gases in 10 insulin-dependent patients. The data were collected at rest and during two levels of submaximal exercises [13].…”

Section: Introductionmentioning

confidence: 99%

“…On the other hand, Minette et al [13]found a normal transfer factor, transfer coefficient, oxygen consumption and arterial blood gases in 10 insulin-dependent patients. The data were collected at rest and during two levels of submaximal exercises [13]. In the English literature, there are very few data concerning pulmonary function abnormalities in patients with type 2 diabetes mellitus (NIDDM).…”

Section: Introductionmentioning

confidence: 99%

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Pulmonary Function in Non-Insulin-Dependent Diabetes mellitus

Marvisi¹,

Bartolini²,

Borrello³

et al. 2001

Respiration

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Background: In type I diabetes mellitus, lung function has been investigated in several clinical studies, but there are few data concerning pulmonary function abnormalities in patients with non-insulin-dependent diabetes mellitus (NIDDM). Objectives: The aim of this study was to assess the presence of pulmonary function abnormalities in patients with NIDDM and to verify the possible associations between diabetic renal microangiopathy, retinopathy and diabetes control. Method and Patients: Thirty patients with NIDDM were collected and divided into two similar groups: subjects with retinopathy and/or diabetic glomerulopathy (group 1, n = 15) and patients without any complications (group 2, n = 15). 17 were males and 13 females, aged from 45 to 81 years. They had had diabetes for 3–23 years and were studied at the Division of Internal Medicine, with an outpatient service for diabetic patients. All patients were non-smokers. The presence of diabetic glomerulopathy was determined by measuring the 24-hour protein excretion rate using the nephelometric method. The presence of retinopathy was determined by using ophthalmoscopy. Glycosylated hemoglobin was measured as an indicator of glycemic control. We performed a global spirometry and measured pulmonary diffusion capacity by the single-breath method corrected by alveolar volume. Results: We found a significant reduction in lung diffusion capacity for carbon monoxide (DL_CO) in the group of patients with other signs of diabetic microangiopathy (p < 0.005) and a significative correlation between DL_COand the grade of albuminuria (r = –0.83, p < 0.001). Conclusions: Pulmonary function abnormalities, in particular a reduction in diffusion capacity, are common in patients with NIDDM and signs of diabetic microangiopathy. A possible explanation is related to an impaired pulmonary microvasculature and alveolar epithelial basal lamina.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Pulmonary Function in Non-Insulin-Dependent Diabetes mellitus

Marvisi¹,

Bartolini²,

Borrello³

et al. 2001

Respiration

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“…Numerous studies of lung function in diabetic subjects have shown slightly decreased indices of forced expiration, lung volumes and diffusion capacity in both type-1 [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17] and type-2 diabetes [18][19][20][21][22][23][24]. Almost all of these studies are cross-sectional and include a small number of patients.…”

mentioning

confidence: 99%

Copenhagen City Heart Study: longitudinal analysis of ventilatory capacity in diabetic and nondiabetic adults

Lange¹,

Parner²,

Schnohr³

et al. 2002

Eur Respir J

102

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The natural history of lung function in diabetes is unknown due to the lack of longitudinal observations. The decline of forced expiratory volume in one second (FEV1) and forced vital capacity (FVC) was studied over 15 yrs in the 17,506 adult participants of The Copenhagen City Heart Study, which included 266 individuals with diabetes.Multiple linear regression and a mixed-effects model were used, taking into account correlation between repeated measurements and adjusting for relevant confounders. In both sexes, FEV1 and FVC were consistently lower in diabetic individuals, compared with healthy individuals, with an average reduction of y8% of the predicted value. Longitudinal analyses showed that the decline of FEV1 and FVC in diabetic individuals was similar to that observed in nondiabetic subjects.It was concluded that although diabetic subjects have, on average, a lower forced expiratory volume in one second and forced vital capacity than individuals without diabetes, this deficit seems not to be progressive in the long term. These observations may be of importance with regard to diabetes treatment with inhaled pulmonary insulin, which is likely to become available within a few years.

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“…In recent years it has been documented that alveolar epithelial and endothelial capillary basal laminae and both fused, are significantly thicker in autopsied patients with diabetes mellitus than in the control subjects [3,4]. Also several authors documented that even in patients lacking manifest pulmonary diseases, there are functional abnormalities in pulmonary gas exchange [5][6][7][8][9].…”

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confidence: 99%

Alveolar Gas Exchange in Patients with Type 2 Diabetes Mellitus

et al. 2003

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Abstract. The present study has been conducted to quantify and compare the capacity of gas exchange in patients with type 2 diabetes mellitus (DM) and healthy controls and also to investigate the effects of various factors on alveolar capillary permeability. A total of 37 subjects, 25 patients with DM and 12 healthy controls were recruited for the study. All the participants were evaluated with simple spirometric tests and simple breath carbonmonoxide (CO) diffusion test (DLCO). The ratio of DLCO value to the alveolar ventilation (VA) was used to assess alveolar membrane permeability. Diabetic patients were also evaluated in detail with respect to degenerative diabetic complications including the presence of microalbuminuria, advanced nephropathy, sensorial and autonomic neuropathy, retinopathy, hypertension and macrovascular disease. The results of simple spirometric tests which determined lung capacity were similar in the diabetic patients and the healthy controls. Ratio of DLCO/VA, which determines alveolar membrane permeability, revealed statistically significant decline in pulmonary gas exchange in the diabetic group (p: 0.037). Pearson correlation analysis revealed statistically significant correlation between duration of diabetes mellitus, age and urinary albumin excretion with p: 0.001; p: 0.036; p: 0.023 respectively). This study demonstrated the decreased alveolar gas exchange capacity in diabetic patients compared with healthy controls. Detrimental effects of DM on alveolar capillaries were found to be correlated with age, duration of DM and urinary albumin excretion. Microalbuminuria was the only significant predictor of DLCO/VA.

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Pulmonary Gas Exchange in Life-Long Nonsmoking Patients with Diabetes mellitus

Cited by 16 publications

References 15 publications

Pulmonary Function in Non-Insulin-Dependent Diabetes mellitus

Pulmonary Function in Non-Insulin-Dependent Diabetes mellitus

Copenhagen City Heart Study: longitudinal analysis of ventilatory capacity in diabetic and nondiabetic adults

Alveolar Gas Exchange in Patients with Type 2 Diabetes Mellitus

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